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What is your opinion about subfascial placement of breast implants in breast augmentation?

I have been hearing a lot about subfascial placement of breast implants and the advantages over other placements. However, many doctors that I have seen in Arizona are either not aware of this placement or they do not recommend this placement for breast augmentation. Do you know why? Is it because it is a new procedure and if so, how new?

A subfascial placement doesn't have any advantage over the more common subpectoral/dual plane technique. The subpectoral technique also places more tissue over the upper part of the implant which helps to decrease rippling in that area, and there is research evidence that capsular contracture is decreased with this placement.

Sincerely,

Thomas C. Wiener, MD

Houston

PlasticSurgery-Houston.com

this information is not a substitute for a consultation with a board certified plastic surgeon

Subfascial breast augmentation places the breast implant beneath a thin layer of fascia on top of the pectoralis muscle and beneath the breast gland. Purported advantages are that the procedure is less involved and less painful than sub-muscular breast augmentation but provides some advantage in terms of capsular contraction to sub-glandular breast augmentation.

In my experience the pectoralis fascia is so thin and often tenuous that in fact many sub-fascial breast augmentations in doubt being at least partially Sub-glandular and lose their benefit. In addition excess bleeding is common in my experience using this technique.

I no longer attempt subfascial placement but prefers sub-muscular breast augmentation and as many cases as possible.

The fascia is a very thin tissue that is between your chest muscle and breast tissue. It is thinner near the base of your breasts and gets minimally thicker as you closer to your neck. Many plastic surgeons don't consider it a very substantial coverage of an average sized implant so it really isn't much different than going simply above the muscle. I personally do not place many breast implants above the muscle because it is commonly believed this places you at a higher risk for capsular contracture and gives less coverage of the implant lending to a less natural look. Different plastic surgeons will have their own opinions so you would be best served by seeing a board-certified plastic surgeon who can examine you and give you their opinion as to what techniques will work best for you,